Nobody Warned You That Perimenopause Would Impact Your Oral Health

TL;DR

• Perimenopause changes your mouth, and that doesn't get talked about enough.

• Delta Dental lists the expected changes plainly: dry mouth, burning mouth, sore gums, weaker bone, and more cavities and gum disease.

• Mayo Clinic names perimenopause as a risk factor for burning mouth syndrome.

• Burning mouth is easy to miss because people who have it often don't have a mouth problem that can be seen during an exam.

• Bone density loss affects your jaw too, not just your hips and spine.

The perimenopause symptom list you got was incomplete

You've probably read the list by now. Hot flashes, trouble sleeping, mood swings, brain fog, joint aches, etc.

Here's what I'd bet wasn't on it: your mouth.

Women in their late 40s or early 50s might get a burning feeling on the tongue. Sometimes it's that everything tastes slightly metallic. Sometimes it's that their gums have started bleeding when they never have before.

Penn Dental, citing Delta Dental data, reports that 51% of women notice changes in their teeth or gums over the years.

As a caveat, that's women generally, across a lifetime, not a menopause-specific figure. So I'm not going to tell you that it proves anything about cause.

The reason this often goes unmentioned is that oral health sits in a gap between your dentist and your gynecologist, and the two of us aren't exactly in the habit of talking to each other.

What estrogen was doing for your mouth

The tissue inside your mouth responds to estrogen. So does the bone that holds your teeth in place. When estrogen starts to swing and then drop, that tissue reacts the same way tissue anywhere else in your body does.

Here's what that looks like.

Your saliva drops. This might sound like a small problem but it does the most damage. Saliva isn't just wetness. The ADA says it cleans the mouth, clears sugar, and protects the tissue inside. When saliva drops, your risk of cavities and gum disease climbs. 

Your gums get touchy. They swell. They bleed. They feel sore. Penn Dental notes that hormone shifts make gums bleed more and pick up infections more easily. Gums can also pull back from the teeth, and that's where a lot of new sensitivity comes from.

Your bone thins, including your jaw. Everyone talks about hips and spine. But the bone around your teeth does the same thing. Less estrogen means weaker bone holding your teeth, and over time, teeth can start to loosen. It's one of the better reasons not to skip cleanings during this stretch of life.

Food tastes different. Metallic, bitter, or just flat. That can push people toward sweet or sour food just to taste something, which is rough on teeth that are already at risk.

About burning mouth

Burning mouth syndrome is a burning or scalding feeling in the mouth and it can show up every day for months. Usually it's the tongue, sometimes the lips or the roof of the mouth. It often comes with a dry mouth and a strange taste. It's often mild in the morning and builds through the day.

Mayo Clinic lists being in perimenopause or past it as a risk factor. 

And as the NIDCR puts it, people with burning mouth often have no problem a dentist can see during an exam. So it gets diagnosed by ruling other things out first.

What actually helps

Treat the dryness now. Drink water on a schedule, not just when you feel thirsty. Chew sugar-free gum. Skip any rinse with alcohol in it, because alcohol dries you out more. If the dryness sticks around, ask us about a stronger fluoride you can't buy off the shelf. 

Don't skip your cleanings. For dry mouth, the ADA says to come in at least twice a year with yearly x-rays. 

Ask about calcium and vitamin D. 

Try an SLS-free toothpaste. SLS is the stuff that makes toothpaste foam up. One review of the research found reports of sore, peeling, burning mouths in people who use it, though the authors say the evidence is still thin.

Ask your doctor about hormone therapy. One study found women who used hormone therapy had a 24% lower risk of losing teeth.

FAQ

Can menopause cause gum problems? 

Yes. Falling estrogen affects the tissue in your mouth directly. That's why sore, swollen, bleeding gums show up now even when nothing about your routine has changed.

Can perimenopause make my teeth sensitive? 

Yes. Usually the gums pull back and leave the root of the tooth exposed. Thinner tissue and dryness add to it. It often shows up before people link it to hormones.

Does hormone therapy help your teeth? 

There's research tying it to a lower risk of tooth loss. Whether it's right for you is a talk to have with your doctor. 

Should I tell my dentist I'm in perimenopause? 

Please do. It changes what we look for and recommend.